In the beginning of the book, Jaime Cortez tells us about work that inspired Sexile and work that was "sampled" to create the illustrations. These illustrations do not simply reiterate the narration; they are an essential part of the drama of the work, they shape the story just as the words do, they affect the reader's emotional depths and climaxes just as the words do.

The swimming illustrations on pages fifty and sixty-four illustrate for the reader two such emotional climaxes and encourage the reader to draw parallels and notice differences between the action and Adela's character in these parts of the book. They are both obviously important. The illustration takes the entire page, providing a visual cue for the reader to pay attention. The first illustration immediately precedes Rolando's death. The second immediately precedes the end of the book. They work as bookends to Adela's transition and the tumultuous discovery that even her loved ones might refuse to love her as herself.

The illustrations throughout are audacious, never shying away from sex or nudity, refusing the "respectability" and sanitization that seem to have invaded queer stories. This reminds me of an Q & A with Samuel Delaney about the illustrations in his graphic novel Bread and Wine when he was asked why he included an explicit picture of oral sex. He answers: “I’m a gay man who came through the AIDS epidemic. The notion that being genteel about intimacy and certain things we don’t show—that kills people! That kills people! And I just did not want to be complicit in murder because I think that’s what it does. This is something ... I feel very, very strongly about that I do not think that in any way, shape or form saying that I am like every other person in the world—I have a sex life, it consists of A, B, C, D, specifically, because everybody’s sex life consists of specific things—I do not think it diminishes my dignity, I do not think it diminishes my humanity, I do not think in any way it should be wrong to do that, and I think the people who do think it’s wrong, are wrong, are very, very wrong, and when they do it to children and adolescents and what have you, they are killing them because the ignorance that goes along with it, that it fosters, the secrecy that it fosters, the lies that it fosters so that various people feel that they can say anything about sex is a very bad and evil thing and I feel myself violently opposed to it.” Like Delaney, Cortez fights against the invasion of respectability and conformity that has invaded queer spaces, choosing instead to assert that queer sex is beautiful and worthy and worthy of beautiful stories beautifully told and beautifully illustrated.